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    Medical Coding

    Learn to apply the current and correct CPT codes across various medical specialties.

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    • Using Administrative Codes to Measure Health Care Quality
      JAMA
      Opinion
      September 6, 2022

      This Viewpoint discusses the need for existing quality and reimbursement programs to adjust their data collection and quality measurement to ensure that data reported and reimbursement provided truly reflect the patient population being treated.

      Health Care Quality Health Policy Health Care Economics, Insurance, Payment
      Full Text | pdf link PDF
    • Association of Insurance Mix and Diagnostic Coding Practices in New York State Hospitals
      JAMA Health Forum
      Research
      September 2, 2022

      This cross-sectional study examines the association between a hospital’s share of privately insured patients and diagnostic coding practices.

      Health Policy Health Care Economics, Insurance, Payment
      Full Text | pdf link PDF open access
    • Use of Medicare’s New Reimbursement Codes for Cognitive Assessment and Care Planning, 2017-2018
      JAMA Network Open
      Research
      September 17, 2021

      This cross-sectional study assesses the use of Medicare's cognitive assessment and care planning codes in the first 2 years of their introduction.

      Health Policy Dementia and Cognitive Impairment Neurology Health Care Economics, Insurance, Payment
      Full Text | pdf link PDF open access
    • Use of and Comorbidities Associated With Diagnostic Codes for COVID-19 in US Health Insurance Claims
      JAMA Network Open
      Research
      September 8, 2021

      This quality improvement study assesses the comorbidities associated with COVID-19 diagnostic codes in US health insurance claims.

      Infectious Diseases Coronavirus (COVID-19) Health Care Economics, Insurance, Payment
      Full Text | pdf link PDF | CME & MOC open access is active quiz
    • Differences in Administrative Claims Data for Coronary Artery Bypass Grafting Between International Classification of Diseases, Ninth Revision and Tenth Revision Coding
      JAMA Cardiology
      Research
      September 1, 2021

      This cross-sectional study examines the changes in coding of coronary artery bypass graft procedures after the transition from the International Classification of Diseases, Ninth Revision to the Tenth Revision.

      Cardiology Cardiothoracic Surgery Surgery Ischemic Heart Disease
      Full Text | pdf link PDF free
    • Uptake and Accuracy of the Diagnosis Code for COVID-19 Among US Hospitalizations
      JAMA
      Research
      December 22, 2020

      This study uses administrative claims data to describe trends in use of ICD-10-CM diagnosis codes for novel coronavirus patients in January-May 2020, before and afer the April 1 release of the U07.1 code to facilitate billing for and case monitoring of COVID-19.

      Coronavirus (COVID-19)
      Full Text | pdf link PDF | CME & MOC free is active quiz
    • Association of Diagnosis Coding With Differences in Risk-Adjusted Short-term Mortality Between Critical Access and Non–Critical Access Hospitals
      JAMA
      Research
      August 4, 2020

      This study uses Medicare data to estimate mortality differences for common medical conditions (pneumonia, heart failure, chronic obstructive pulmonary disease, urinary tract infection, others) at US critical access vs non–critical access hospitals between 2007 and 2017 with vs without adjustment for discharge diagnosis counts to assess the extent to which coding practices rather than illness severity might account for observed mortality differences.

      Health Disparities Health Policy Cardiology Chronic Obstructive Pulmonary Disease Pulmonary Medicine
      Full Text | pdf link PDF free
    • Relative Value Units and the Measurement of Physician Performance
      JAMA
      Opinion
      September 24, 2019

      This Viewpoint argues for separation of physician performance measurement from RVU production as a means to refocus physicians away from billing toward patient-centered values that could improve patients’ experience, reduce potential harms from the overtreatment that RVUs incentivize, and improve physicians’ work life and satisfaction.

      Health Care Economics, Insurance, Payment Health Policy Performance Measures
      Full Text | pdf link PDF has multimedia
    • Measurement of Fall Injury With Health Care System Data and Assessment of Inclusiveness and Validity of Measurement Models
      JAMA Network Open
      Research
      August 21, 2019

      This diagnostic study uses Health and Retirement Survey and linked Medicare data to develop and validate an administrative approach to identifying older adults with fall-related injuries and to quantify the inclusiveness and validity across a spectrum of potential diagnoses of fall-related injuries.

      Geriatrics Trauma and Injury Emergency Medicine
      Full Text | pdf link PDF open access
    • The Review of Systems, the Electronic Health Record, and Billing
      JAMA
      Opinion
      July 9, 2019

      In the context of a Centers for Medicare & Medicaid Services proposal to simplify evaluation and management (E/M) documentation guidelines by 2021, this Viewpoint reviews the problems with current implementation of review-of-systems history taking in electronic health records (EHRs), including information overload, lack of follow-up of findings, clinical irrelevance to some patients and visits, and dishonesty in documentation.

      Patient Care Workflow and Process Technology and Finance Electronic Health Records Health Care Economics, Insurance, Payment
      Full Text | pdf link PDF has multimedia
    • Gaming, Upcoding, Fraud, and the Stubborn Persistence of Unstable Angina
      JAMA Internal Medicine
      Opinion
      February 1, 2019
      Acute Coronary Syndromes Cardiology Ischemic Heart Disease Percutaneous Coronary Intervention Health Care Economics, Insurance, Payment
      Full Text | pdf link PDF has multimedia
    • Temporal Trends in Unstable Angina Diagnosis Codes for Outpatient Percutaneous Coronary Interventions
      JAMA Internal Medicine
      Research
      February 1, 2019

      This study examines the appropriate use of percutaneous coronary interventions in New York, Michigan, and Florida using Healthcare Cost and Utilization Project state databases.

      Cardiology Percutaneous Coronary Intervention Ischemic Heart Disease Acute Coronary Syndromes Health Care Economics, Insurance, Payment
      Full Text | pdf link PDF free has multimedia
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